Assuntos
Hipertensão/tratamento farmacológico , Falência Renal Crônica/complicações , Anti-Hipertensivos/classificação , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Capilares/fisiopatologia , Criança , Humanos , Hipertensão/etiologia , Glomérulos Renais/irrigação sanguínea , Glomérulos Renais/fisiopatologia , Microcirculação , PrevalênciaRESUMO
Because the pathogenesis of acute renal failure is multifactorial, clinical evaluation and ancillary studies must be performed systematically to reliably differentiate the various disorders. This assessment includes measurement of the serum creatinine and urea concentrations, urine composition and flow rate, and fractional excretion of sodium. Radiodiagnostic techniques such as ultrasound, radionuclide renal scans, and nuclear magnetic resonance may provide useful anatomic and functional information. With this data base, the physician can prescribe an individualized management plan that addresses the fluid, metabolic, and nutritional necessities of the child.
Assuntos
Injúria Renal Aguda/terapia , Injúria Renal Aguda/prevenção & controle , Criança , Pré-Escolar , Terapia Combinada , Proteínas Alimentares/administração & dosagem , Dopamina/uso terapêutico , Feminino , Hidratação , Furosemida/uso terapêutico , Humanos , Masculino , Manitol/uso terapêutico , Minerais/administração & dosagem , Necessidades Nutricionais , Diálise Peritoneal , Oligoelementos/uso terapêuticoAssuntos
Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/diagnóstico por imagem , Injúria Renal Aguda/urina , Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Taxa de Filtração Glomerular , Humanos , Isquemia/fisiopatologia , Rim/irrigação sanguínea , Néfrons/efeitos dos fármacos , CintilografiaRESUMO
An estimate of glomerular filtration rate has been derived for children from body length (L, in centimeters) and plasma creatinine (Pcr, in milligrams per deciliter): GFR = 0.55 L/Pcr. The near universality of this estimate in children led us to seek a similar formula for estimating GFR in full-term infants during the first year of life. We measured Pcr in 137 healthy infants and performed creatinine clearance (Ccr) studies in 63 of them aged greater than or equal to 5 days. Beyond the first week, Pcr averaged 0.39 +/- 0.01 (0.10 SD) mg/dl. The estimate of GFR from 0.55 L/Pcr overestimated Ccr by 24% (P less than 0.001). Based on the calculation of a new constant from Ccr X Pcr/L, GFR was more accurately estimated from 0.45 L/Pcr (mean difference of Ccr - 0.45 L/Pcr = -0.4 +/- 3.7 (SE) ml/min X 1.73 m2) in full-term infants between 1 and 52 weeks of age. Because the constant 0.45 and Pcr do not change significantly during this period, GFR can be approximated at the bedside from body length of the healthy full-term infant (GFR = 0.45 L/0.39 = 1.1 L).